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van der Waal C, Embrechts E, Truijen S, Saeys W. Do we need to consider head-on-body position, starting roll position and presence of visuospatial neglect when assessing perception of verticality after stroke? Top Stroke Rehabil 2024; 31:244-258. [PMID: 37671676 DOI: 10.1080/10749357.2023.2253622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/27/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND AND OBJECTIVE Considering various factors that influence the accuracy of the Subjective Visual Vertical (SVV) and Subjective Postural Vertical (SPV), standardization of assessment methods is needed. This retrospective study examined the contribution of Head-on-Body (HOB) position, starting roll position (SRP) and visuospatial neglect (VSN) to SVV and SPV constant errors (i.e. deviation from true vertical). Also, the contribution of HOB position and VSN presence to SVV and SPV variability (i.e. intra-individual consistency between trials) was assessed. METHODS First-ever unilateral hemispheric stroke survivors (<85 years; <100 days post-stroke) were assessed with three HOB positions (neutral, contralesional, and ipsilesional) and seven starting positions (20°Contralesional to 20° ipsilesional) of the laser bar and tilt chair. Linear mixed models were selected to evaluate the contribution of HOB, SRP, and VSN to SVV/SPV constant errors and variability. RESULTS Thirty-four subjects (24 VSN-/10 VSN+) were assessed. A tilted HOB position led to significantly higher constant errors for the SVV and SPV (the latter only in the VSN- group), and an increased SVV variability. SRP only significantly contributed to the SVV constant errors and only in the VSN- group. Furthermore, the presence of VSN resulted in a significantly higher SVV and SPV variability. CONCLUSIONS HOB position and the presence of SRP and VSN are important factors to consider during SVV and SPV measurements. Assessment with a neutral HOB position leads to more accurate results. HOB position and SRP influence the results of SVV and SPV differently in individuals with and without VSN, which highlights the relevance of VSN assessment.
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Affiliation(s)
- Charlotte van der Waal
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Elissa Embrechts
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
- Department of Experimental Neuropsychology, Helmholtz Institute, Utrecht University, Utrecht, Netherlands
| | - Steven Truijen
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Wim Saeys
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
- Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
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Embrechts E, Schröder J, Nijboer TCW, van der Waal C, Lafosse C, Truijen S, Saeys W. Does visuospatial neglect contribute to standing balance within the first 12 weeks post-stroke? A prospective longitudinal cohort study. BMC Neurol 2024; 24:37. [PMID: 38254026 PMCID: PMC10801963 DOI: 10.1186/s12883-023-03475-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 11/24/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Visuospatial neglect (VSN) has been suggested to limit standing balance improvement post-stroke. However, studies investigating this association longitudinally by means of repeated within-subject measurements early post-stroke are lacking. This prospective longitudinal cohort study evaluates the longitudinal association of egocentric and allocentric VSN severity with 1) standing balance independence and 2) postural control and weight-bearing asymmetry (WBA) during quiet standing, in the first 12 weeks post-stroke. METHODS Thirty-six hemiplegic individuals after a first-ever unilateral stroke were evaluated at weeks 3, 5, 8 and 12 post-stroke. Egocentric and allocentric VSN severity were evaluated using the Broken Hearts Test. The standing unperturbed item of the Berg Balance Scale (BBS-s) was used to clinically evaluate standing independence. Posturographic measures included measures of postural control (mediolateral (ML)/anteroposterior (AP) net center-of-pressure velocities (COPvel)) and WBA during quiet standing. A linear mixed model was used to examine longitudinal associations between egocentric and allocentric VSN, and BBS-s, COPvel-ML, COPvel-AP and WBA within the first 12 weeks post-stroke. RESULTS Egocentric (β = -0.08, 95%CI[-0.15;-0.01], P = .029) and allocentric VSN severity (β = -0.09, 95%CI[-0.15; -0.04], P = .002) were significant independent factors for BBS-s scores in the first 12 weeks post-stroke. Egocentric and allocentric VSN were no significant independent factors for COPvel-ML, COPvel-AP and WBA in the first 12 weeks post-stroke. CONCLUSIONS Allocentric and egocentric VSN severity were significantly associated with decreased standing independence, but not impaired postural control or greater asymmetric weight-bearing, in the early subacute post-stroke phase. This may involve traditional VSN measures being not sensitive enough to detect fine-grained VSN deficits due to a ceiling effect between 5 and 8 weeks post-stroke, once the individual regains standing ability. Future studies may require more sensitive VSN measurements to detect such deficits. Trial registration Clinicaltrials.gov. unique identifier NCT05060458.
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Affiliation(s)
- Elissa Embrechts
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Wilrijk, Belgium.
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands.
| | - Jonas Schröder
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Wilrijk, Belgium
| | - Tanja C W Nijboer
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
- Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Charlotte van der Waal
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Wilrijk, Belgium
| | - Christophe Lafosse
- Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
| | - Steven Truijen
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Wilrijk, Belgium
| | - Wim Saeys
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Wilrijk, Belgium
- Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
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Tani K, Iio S, Kamiya M, Yoshizawa K, Shigematsu T, Fujishima I, Tanaka S. Neuroanatomy of reduced distortion of body-centred spatial coding during body tilt in stroke patients. Sci Rep 2023; 13:11853. [PMID: 37481585 PMCID: PMC10363170 DOI: 10.1038/s41598-023-38751-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 07/14/2023] [Indexed: 07/24/2023] Open
Abstract
Awareness of the direction of the body's (longitudinal) axis is fundamental for action and perception. The perceived body axis orientation is strongly biased during body tilt; however, the neural substrates underlying this phenomenon remain largely unknown. Here, we tackled this issue using a neuropsychological approach in patients with hemispheric stroke. Thirty-seven stroke patients and 20 age-matched healthy controls adjusted a visual line with the perceived body longitudinal axis when the body was upright or laterally tilted by 10 degrees. The bias of the perceived body axis caused by body tilt, termed tilt-dependent error (TDE), was compared between the groups. The TDE was significantly smaller (i.e., less affected performance by body tilt) in the stroke group (15.9 ± 15.9°) than in the control group (25.7 ± 17.1°). Lesion subtraction analysis and Bayesian lesion-symptom inference revealed that the abnormally reduced TDEs were associated with lesions in the right occipitotemporal cortex, such as the superior and middle temporal gyri. Our findings contribute to a better understanding of the neuroanatomy of body-centred spatial coding during whole-body tilt.
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Affiliation(s)
- Keisuke Tani
- Laboratory of Psychology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, 431-3192, Japan.
- Faculty of Psychology, Otemon Gakuin University, 2-1-15 Nishi-Ai, Ibaraki, Osaka, 567-8502, Japan.
| | - Shintaro Iio
- Department of Rehabilitation, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Shizuoka, 433-8511, Japan
| | - Masato Kamiya
- Department of Rehabilitation, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Shizuoka, 433-8511, Japan
| | - Kohei Yoshizawa
- Department of Rehabilitation, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Shizuoka, 433-8511, Japan
| | - Takashi Shigematsu
- Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Shizuoka, 433-8511, Japan
| | - Ichiro Fujishima
- Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Shizuoka, 433-8511, Japan
| | - Satoshi Tanaka
- Laboratory of Psychology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, 431-3192, Japan
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van der Waal C, Embrechts E, Loureiro-Chaves R, Gebruers N, Truijen S, Saeys W. Lateropulsion with active pushing in stroke patients: its link with lesion location and the perception of verticality. A systematic review. Top Stroke Rehabil 2023; 30:281-297. [PMID: 35102816 DOI: 10.1080/10749357.2022.2026563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Lateropulsion with active Pushing (LwP) is characterized by impairments in postural control. Previous research suggests an association between LwP, lesion location and verticality misperception. This first-ever systematic review evaluates the association between LwP, lesion location and the perception of verticality (PROSPERO: CRD42020159248). METHODS PubMed, Web of Science, REHABDATA, Embase, Cochrane Library and PEDro were systematically searched on December 16, 2021. Studies were included when examining lesion location or perception of verticality (Subjective Haptic, Visual or Postural Vertical) in supratentorial stroke patients showing LwP. Two reviewers independently screened and assessed risk of bias using the Newcastle Ottawa Scale. Data were qualitatively analyzed and extracted. RESULTS Nineteen studies were included, examining a total of 340 LwP patients. Lesions in: the thalamus, internal capsule, inferior parietal lobule at the junction of the postcentral gyrus, the posterior insula and the superior temporal gyrus, were associated with LwP. Whereas all studies examining the Subjective Postural and Haptic Vertical (haptic only examined once) reported a significant increased deviation in LwP patients, inconsistent results were found for the Subjective Visual Vertical. Furthermore, the Subjective Visual and Postural Vertical showed inconsistent results for magnitude, direction and variability of this deviation. DISCUSSION A complex brain network, rather than only one brain region, seems responsible for body control with respect to gravity. A disruption within this network might lead to a bias in the construction of a correct internal reference frame, crucial for perceiving verticality. There was an association of LwP with verticality misperception in all three modalities.
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Affiliation(s)
- Charlotte van der Waal
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Elissa Embrechts
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Renata Loureiro-Chaves
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Nick Gebruers
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Steven Truijen
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Wim Saeys
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium.,Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
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Embrechts E, van der Waal C, Anseeuw D, van Buijnderen J, Leroij A, Lafosse C, Nijboer TC, Truijen S, Saeys W. Association between spatial neglect and impaired verticality perception after stroke: A systematic review. Ann Phys Rehabil Med 2022; 66:101700. [PMID: 35963568 DOI: 10.1016/j.rehab.2022.101700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 07/01/2022] [Accepted: 07/02/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Although most research on spatial neglect (SN) has focused on spatial perception deficits with regard to the lateral (left-right) axis, deficits of spatial perception with regard to the vertical (up-down) axis, such as disturbances in the perception of verticality (e.g., judgement of vertical orientations), have also been suggested. OBJECTIVE We aimed to systematically analyse reported associations between SN and characteristics of verticality perception while considering the time post-stroke. METHODS PubMed, Web of Science, Scopus, PubPsych and PsycArticles databases were searched on May 24, 2022 for articles written in English that evaluated the association between SN and verticality perception (i.e., the subjective visual vertical [SVV], subjective postural vertical [SPV] and subjective haptic vertical [SHV]) in adults after stroke. Left and right SN were considered and had to be assessed using standardized methods. Data were manually extracted, and risk of bias was assessed with the Newcastle-Ottawa Scale. The tilt of the line/chair relative to the gravitational vector and its direction, together with uncertainty (i.e., variability across measurements), were evaluated. RESULTS Thirteen studies were included (431 participants after stroke); at least 191 participants exhibited SN. Mainly the first 3 to 6 months post-stroke were evaluated. SN was associated with SVV misperception, which resulted in larger SVV tilts (mostly in the contralesional direction) and uncertainty in participants with than without SN. SVV tilt magnitudes ranged from a mean/median of -8.9° to -2.3° in SN participants and from -1.6° to 0.6° in non-SN participants, the latter falling within normative ranges. For SPV and SHV measurements, the magnitude of tilt and the uncertainty were insufficiently assessed or results were inconclusive. CONCLUSIONS SN was associated with larger SVV tilts and uncertainty, which suggests that SVV misperception is a key feature of SN. This observation highlights the importance of regular SVV assessment in people with SN in clinical practice. PROSPERO CRD42019127616.
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Affiliation(s)
- Elissa Embrechts
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium; Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, the Netherlands.
| | - Charlotte van der Waal
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Dorine Anseeuw
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Jessica van Buijnderen
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Améline Leroij
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Christophe Lafosse
- Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
| | - Tanja Cw Nijboer
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, the Netherlands; Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Steven Truijen
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Wim Saeys
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium; Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
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赵 雅, 陈 钢, 吴 佳, 杨 捷, 周 丽, 李 莹. [Clinical application progress of subjective visual vertical test]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2022; 36:884-892. [PMID: 36347586 PMCID: PMC10127558 DOI: 10.13201/j.issn.2096-7993.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Indexed: 06/16/2023]
Abstract
Subjective visual vertical test is considered as an effective technique to evaluate otolith organ function and central pathway of gravity perception. This test is non-invasive, easy to operate and has little stimulation. At present, there are few such studies in China. This paper reviews the concept, measurement principle and method, influencing factors, application, advantages and disadvantages of subjective visual vertical test.
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Affiliation(s)
- 雅楠 赵
- 山西医科大学护理学院(太原,030001)College of Nursing, Shanxi Medical University, Taiyuan, 030001, China
| | - 钢钢 陈
- 山西医科大学第一医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University
| | - 佳鑫 吴
- 山西医科大学第一医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University
| | - 捷 杨
- 山西医科大学第一医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University
| | - 丽媛 周
- 山西医科大学第一医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University
| | - 莹 李
- 山西医科大学第一医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University
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Stefano LHS, Favoretto DB, Nascimento DC, Santos LRA, Louzada F, Bikson M, Leite JP, Pontes-Neto OM, Edwards DJ, Edwards TGS. Middle cerebral artery blood flow stability in response to high-definition transcranial electrical stimulation: a randomized sham-controlled clinical trial. Clin Neurol Neurosurg 2022; 220:107345. [DOI: 10.1016/j.clineuro.2022.107345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/11/2022] [Accepted: 06/16/2022] [Indexed: 11/28/2022]
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Tohyama T, Kondo K, Otaka Y. Effects of Galvanic Vestibular Stimulation on Visual Verticality and Standing Posture Differ Based on the Polarity of the Stimulation and Hemispheric Lesion Side in Patients With Stroke. Front Neurol 2021; 12:768663. [PMID: 34858316 PMCID: PMC8631773 DOI: 10.3389/fneur.2021.768663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/08/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction: There is growing evidence supporting the relationship of vertical misperception and poor balance control with asymmetrical standing posture in patients with stroke. Although the vestibular system has been shown to be responsible for vertical misperception and balance disorders, the effect of galvanic vestibular stimulation (GVS) on both vertical misperception and postural asymmetry after stroke remains elusive. The aim of this study was to investigate the effects of GVS on visual verticality and postural asymmetry after stroke and to clarify whether the effects differ depending on the polarity of the stimulation and hemispheric lesion side. Methods: We measured the subjective visual vertical (SVV) and body weight distribution on each foot in an upright stance in 24 patients with a hemispheric stroke (10 with a left hemisphere lesion and 14 with a right hemisphere lesion) and nine age-matched healthy controls. During the measurements, bipolar GVS (1.5 mA) was applied over the bilateral mastoid processes in three stimulation conditions: contralesional-anodal and ipsilesional-cathodal vestibular stimulation, ipsilesional-anodal and contralesional-cathodal vestibular stimulation, and no stimulation. To examine whether GVS modulates visual verticality and standing posture, SVV and weight-bearing in the three conditions were analyzed. Results: During no stimulation, the SVV deviated to the contralesional side in patients with a right hemisphere lesion, while more weight-bearing was observed on the ipsilesional limb than on the contralesional limb in both patient groups than in the controls. The SVV was modulated by reversing the polarity of GVS in all the groups when the cathodal stimulus side was either ipsilateral or contralateral to the lesion while the ipsilesional-cathodal vestibular stimulation reduced weight-bearing asymmetry in only the patients with a right hemisphere lesion. Conclusions: These findings demonstrate that the effects of GVS on the SVV and standing posture differ depending on the polarity of GVS and the hemispheric lesion side. Patients with a right hemisphere lesion have difficulty maintaining their preferred standing posture under visual verticality modulation evoked by GVS. The application of GVS may clarify whether the vestibular system has neural redundancy after stroke to suppress any effects of the stimulation, including modulation of the visual verticality, on balance.
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Affiliation(s)
- Takamichi Tohyama
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Narashino, Japan.,Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Kunitsugu Kondo
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Narashino, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Narashino, Japan.,Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
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Ferreira LR, Ferreira FJPDA, Campos FA, Luvizutto GJ, Souza LAPSD. Evaluation of subjective vertical perception among stroke patients: a systematic review. ARQUIVOS DE NEURO-PSIQUIATRIA 2021; 79:1026-1034. [PMID: 34816993 DOI: 10.1590/0004-282x-anp-2020-0584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/25/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Verticality misperception is relatively common among patients after stroke, and it may be evaluated in terms of (a) subjective visual vertical (SVV), (b) subjective haptic vertical (SHV) and (c) subjective postural vertical (SPV). To better understand these assessment methods, we conducted a systematic review of the methodological characteristics of different protocols for evaluating SVV, SHV and SPV among individuals after stroke. OBJECTIVE To standardize the methodological characteristics of protocols for evaluating verticality perception after stroke. METHODS We searched the following databases: PUBMED, regional BVS portal (MEDLINE, LILACS, IBECS, CUBMED, Psychology Index and LIS), CINAHL, SCOPUS, Web of Science, Science Direct, Cochrane Library and PEDro. Two review authors independently used the QUADAS method (Quality Assessment of Diagnostic Accuracy Studies) and extracted data. RESULTS We included 21 studies in the review: most (80.9%) used SVV, eight (38.1%) used SPV and four (19.0%) used SHV. We observed high variability in assessments of verticality perception, due to patient positions, devices used, numbers of repetitions and angle of inclination for starting the tests. CONCLUSION This systematic review was one of the first to explore all the methods of assessing verticality perception after stroke, and it provides crucial information on how to perform the tests, in order to guide future researchers/clinicians.
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Affiliation(s)
| | | | | | - Gustavo José Luvizutto
- Universidade Federal do Triângulo Mineiro, Departamento de Fisioterapia Aplicada, Uberaba MG, Brazil
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Hugues A, Guinet-Lacoste A, Bin S, Villeneuve L, Lunven M, Pérennou D, Giraux P, Foncelle A, Rossetti Y, Jacquin-Courtois S, Luauté J, Rode G. Effects of prismatic adaptation on balance and postural disorders in patients with chronic right stroke: protocol for a multicentre double-blind randomised sham-controlled trial. BMJ Open 2021; 11:e052086. [PMID: 34819284 PMCID: PMC8614142 DOI: 10.1136/bmjopen-2021-052086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 10/21/2021] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Patients with right stroke lesion have postural and balance disorders, including weight-bearing asymmetry, more pronounced than patients with left stroke lesion. Spatial cognition disorders post-stroke, such as misperceptions of subjective straight-ahead and subjective longitudinal body axis, are suspected to be involved in these postural and balance disorders. Prismatic adaptation has showed beneficial effects to reduce visuomotor disorders but also an expansion of effects on cognitive functions, including spatial cognition. Preliminary studies with a low level of evidence have suggested positive effects of prismatic adaptation on weight-bearing asymmetry and balance after stroke. The objective is to investigate the effects of this intervention on balance but also on postural disorders, subjective straight-ahead, longitudinal body axis and autonomy in patients with chronic right stroke lesion. METHODS AND ANALYSIS In this multicentre randomised double-blind sham-controlled trial, we will include 28 patients aged from 18 to 80 years, with a first right supratentorial stroke lesion at chronic stage (≥12 months) and having a bearing ≥60% of body weight on the right lower limb. Participants will be randomly assigned to the experimental group (performing pointing tasks while wearing glasses shifting optical axis of 10 degrees towards the right side) or to the control group (performing the same procedure while wearing neutral glasses without optical deviation). All participants will receive a 20 min daily session for 2 weeks in addition to conventional rehabilitation. The primary outcome will be the balance measured using the Berg Balance Scale. Secondary outcomes will include weight-bearing asymmetry and parameters of body sway during static posturographic assessments, as well as lateropulsion (measured using the Scale for Contraversive Pushing), subjective straight-ahead, longitudinal body axis and autonomy (measured using the Barthel Index). ETHICS AND DISSEMINATION The study has been approved by the ethical review board in France. Findings will be submitted to peer-reviewed journals relative to rehabilitation or stroke. TRIAL REGISTRATION NUMBER NCT03154138.
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Affiliation(s)
- Aurélien Hugues
- Service de médecine physique et réadaptation, hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis Laval, France
- Equipe 'Trajectoires', Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
- Plate-forme 'Mouvement et Handicap', hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
| | - Amandine Guinet-Lacoste
- Service de médecine physique et réadaptation, hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis Laval, France
- Equipe 'Trajectoires', Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
- Plate-forme 'Mouvement et Handicap', hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
| | - Sylvie Bin
- Service de Recherche Clinique et Epidémiologique, Pôle de Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Laurent Villeneuve
- Service de Recherche Clinique et Epidémiologique, Pôle de Santé Publique, Hospices Civils de Lyon, Lyon, France
- EMR 3738, Université Lyon 1, Villeurbanne, France
| | - Marine Lunven
- Département d'Etudes Cognitives, École normale supérieure, PSL University, Paris, France
- Hôpital Henri Mondor-Albert Chenevier, Centre de référence Maladie de Huntington, Service de Neurologie, AP-HP, Créteil, France
- INSERM U955, Institut Mondor de Recherche Biomédicale, Equipe NeuroPsychologie Interventionnelle, Université Paris Est Créteil, Créteil, France
| | - Dominic Pérennou
- Département de médecine physique et de réadaptation, Institut de rééducation, Hôpital sud, Centre Hospitalier Universitaire Grenoble-Alpes, Grenoble, France
- Laboratoire Neurosciences Cognitives, CNRS UMR5105, Université Grenoble Alpes, Grenoble, France
| | - Pascal Giraux
- Service de médecine physique et réadaptation, Hôpital Bellevue, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
- Laboratoire Inter-universitaire de Biologie de la Motricité (LIBM, EA 7424), Université Jean Monnet Saint-Etienne, Université de Lyon, Saint-Etienne, France
| | - Alexandre Foncelle
- Equipe 'Trajectoires', Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
| | - Yves Rossetti
- Service de médecine physique et réadaptation, hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis Laval, France
- Equipe 'Trajectoires', Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
- Plate-forme 'Mouvement et Handicap', hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
| | - Sophie Jacquin-Courtois
- Service de médecine physique et réadaptation, hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis Laval, France
- Equipe 'Trajectoires', Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
- Plate-forme 'Mouvement et Handicap', hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
| | - Jacques Luauté
- Service de médecine physique et réadaptation, hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis Laval, France
- Equipe 'Trajectoires', Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
- Plate-forme 'Mouvement et Handicap', hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
| | - Gilles Rode
- Service de médecine physique et réadaptation, hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis Laval, France
- Equipe 'Trajectoires', Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
- Plate-forme 'Mouvement et Handicap', hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
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11
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Benady A, Zadik S, Zeilig G, Gilaie-Dotan S, Plotnik M. Gait Speed Modulations Are Proportional to Grades of Virtual Visual Slopes-A Virtual Reality Study. Front Neurol 2021; 12:615242. [PMID: 34512493 PMCID: PMC8425350 DOI: 10.3389/fneur.2021.615242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 07/14/2021] [Indexed: 11/17/2022] Open
Abstract
Gait is a complex mechanism relying on integration of several sensory inputs such as vestibular, proprioceptive, and visual cues to maintain stability while walking. Often humans adapt their gait to changes in surface inclinations, and this is typically achieved by modulating walking speed according to the inclination in order to counteract the gravitational forces, either uphill (exertion effect) or downhill (braking effect). The contribution of vision to these speed modulations is not fully understood. Here we assessed gait speed effects by parametrically manipulating the discrepancy between virtual visual inclination and the actual surface inclination (aka visual incongruence). Fifteen healthy participants walked in a large-scale virtual reality (VR) system on a self-paced treadmill synchronized with projected visual scenes. During walking they were randomly exposed to varying degrees of physical-visual incongruence inclinations (e.g., treadmill leveled & visual scene uphill) in a wide range of inclinations (−15° to +15°). We observed an approximately linear relation between the relative change in gait speed and the anticipated gravitational forces associated with the virtual inclinations. Mean relative gait speed increase of ~7%, ~11%, and ~17% were measured for virtual inclinations of +5°, +10°, and +15°, respectively (anticipated decelerating forces were proportional to sin[5°], sin[10°], sin[15°]). The same pattern was seen for downhill virtual inclinations with relative gait speed modulations of ~-10%, ~-16%, and ~-24% for inclinations of −5°, −10°, and −15°, respectively (in anticipation of accelerating forces). Furthermore, we observed that the magnitude of speed modulation following virtual inclination at ±10° was associated with subjective visual verticality misperception. In conclusion, visual cues modulate gait speed when surface inclinations change proportional to the anticipated effect of the gravitational force associated the inclinations. Our results emphasize the contribution of vision to locomotion in a dynamic environment and may enhance personalized rehabilitation strategies for gait speed modulations in neurological patients with gait impairments.
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Affiliation(s)
- Amit Benady
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel.,School of Optometry and Vision Science, Bar Ilan University, Ramat Gan, Israel.,The Gonda Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel
| | - Sean Zadik
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel
| | - Gabriel Zeilig
- Department of Neurological Rehabilitation, Sheba Medical Center, Ramat Gan, Israel.,Department of Physical and Rehabilitation Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,School of Health Professions, Ono Academic College, Kiryat Ono, Israel
| | - Sharon Gilaie-Dotan
- School of Optometry and Vision Science, Bar Ilan University, Ramat Gan, Israel.,The Gonda Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel.,UCL Institute of Cognitive Neuroscience, London, United Kingdom
| | - Meir Plotnik
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel.,Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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12
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Tani K, Tanaka S. Neuroanatomical correlates of the perception of body axis orientation during body tilt: a voxel-based morphometry study. Sci Rep 2021; 11:14659. [PMID: 34282178 PMCID: PMC8289860 DOI: 10.1038/s41598-021-93961-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/05/2021] [Indexed: 11/23/2022] Open
Abstract
Accurate perception of the orientations of the body axis and gravity is essential for actions. The ability to perceive these orientations during head and body tilt varies across individuals, and its underlying neural basis is unknown. To address this, we investigated the association between inter-individual differences in local gray matter (GM) volume and inter-individual differences in the ability to estimate the directions of body longitudinal axis or gravity during whole-body tilt using voxel-based morphometry (VBM) analysis in 50 healthy adults (20–46 years, 25 men and 25 women). Although no anatomical regions were identified relating to performance requiring estimates of gravitational direction, we found a significant correlation between the GM volume in the right middle occipital gyrus and the ability to estimate the body axis orientation. This finding provides the first evidence on neuroanatomical substrates of the perception of body axis orientation during body tilt.
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Affiliation(s)
- Keisuke Tani
- Laboratory of Psychology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan. .,Faculty of Psychology, Otemon Gakuin University, 2-1-15 Nishi-Ai , Ibaraki, Osaka, 567-8502, Japan.
| | - Satoshi Tanaka
- Laboratory of Psychology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
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13
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Pascucci Sande de Souza LA, Ferreira LR, Silva Bitencourt AC, Bazan R, Luvizutto GJ. Visual and haptic verticality misperception and trunk control within 72 h after stroke. J Bodyw Mov Ther 2021; 27:676-681. [PMID: 34391306 DOI: 10.1016/j.jbmt.2021.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 03/29/2021] [Accepted: 05/07/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Stroke patients often exhibit an altered perception of verticality, but there are no studies evaluating verticality perception in the first 72 h after stroke and its relationship with trunk control. Therefore, this study aimed to analyze visual and haptic verticality in the acute phase of stroke. METHODS This was a cross-sectional study conducted with two groups: (a) 13 individuals with stroke and (b) 12 healthy participants. We assessed verticality via the subjective visual vertical (SVV) and the subjective haptic vertical (SHV); and we measured trunk control with the Trunk Impairment Scale (TIS). We performed t-tests to compare the SVV and SHV between groups. Pearson correlation was performed between verticality tests with National Institutes of Health Stroke Scale (NIHSS) and the TIS. RESULTS Participants with recent stroke presented higher true and absolute SVV deviation values than did the control group. There was significant negative correlation between absolute (r = -0.57; p = 0.02) and true SVV (r = -0.54; p = 0.01) with TIS scores There was also significant positive correlation between absolute (r = 0.63; p = 0.009) and true SVV (r = 0.61; p = 0.003) with NIHSS. A significant negative correlation between NIHSS and TIS scores also was found (r = -0.80; p = 0.005). CONCLUSION Individuals with acute stroke presented larger variability in their perceptions of visual verticality than did healthy controls, and verticality perceptions were positively correlated with trunk impairment.
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Affiliation(s)
| | - Luana Ribeiro Ferreira
- Master's Program in Physical Therapy, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Ana Carolina Silva Bitencourt
- Master's Program in Physical Therapy, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Rodrigo Bazan
- Department of Neurology, Botucatu Medical School (UNESP), Botucatu, São Paulo, Brazil
| | - Gustavo José Luvizutto
- Department of Applied Physical Therapy, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil.
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14
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Benady A, Zadik S, Ben-Gal O, Cano Porras D, Wenkert A, Gilaie-Dotan S, Plotnik M. Vision Affects Gait Speed but not Patterns of Muscle Activation During Inclined Walking-A Virtual Reality Study. Front Bioeng Biotechnol 2021; 9:632594. [PMID: 33898402 PMCID: PMC8062981 DOI: 10.3389/fbioe.2021.632594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/04/2021] [Indexed: 12/22/2022] Open
Abstract
While walking, our locomotion is affected by and adapts to the environment based on vision- and body-based (vestibular and proprioception) cues. When transitioning to downhill walking, we modulate gait by braking to avoid uncontrolled acceleration, and when transitioning to uphill walking, we exert effort to avoid deceleration. In this study, we aimed to measure the influence of visual inputs on this behavior and on muscle activation. Specifically, we aimed to explore whether the gait speed modulations triggered by mere visual cues after transitioning to virtually inclined surface walking are accompanied by changes in muscle activation patterns typical to those triggered by veridical (gravitational) surface inclination transitions. We used an immersive virtual reality system equipped with a self-paced treadmill and projected visual scenes that allowed us to modulate physical-visual inclination congruence parametrically. Gait speed and leg muscle electromyography were measured in 12 healthy young adults. In addition, the magnitude of subjective visual verticality misperception (SVV) was measured by the rod and frame test. During virtual (non-veridical) inclination transitions, vision modulated gait speed by (i) slowing down to counteract the excepted gravitational "boost" in virtual downhill inclinations and (ii) speeding up to counteract the expected gravity resistance in virtual uphill inclinations. These gait speed modulations were reflected in muscle activation intensity changes and associated with SVV misperception. However, temporal patterns of muscle activation were not affected by virtual (visual) inclination transitions. Our results delineate the contribution of vision to locomotion and may lead to enhanced rehabilitation strategies for neurological disorders affecting movement.
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Affiliation(s)
- Amit Benady
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel
- St George’s University of London Medical School, Sheba Medical Center, Ramat Gan, Israel
- School of Optometry and Vision Science, Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, Israel
| | - Sean Zadik
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel
- St George’s University of London Medical School, Sheba Medical Center, Ramat Gan, Israel
| | - Oran Ben-Gal
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel
| | - Desiderio Cano Porras
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel
- Brightlands Institute for Smart Society (BISS), Maastricht University, Maastricht, Netherlands
| | - Atalia Wenkert
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel
| | - Sharon Gilaie-Dotan
- School of Optometry and Vision Science, Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, Israel
- UCL Institute of Cognitive Neuroscience, London, United Kingdom
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| | - Meir Plotnik
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel
- Department of Physiology and Pharmacology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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Embrechts E, Van Criekinge T, Schröder J, Nijboer T, Lafosse C, Truijen S, Saeys W. The association between visuospatial neglect and balance and mobility post-stroke onset: A systematic review. Ann Phys Rehabil Med 2020; 64:101449. [PMID: 33152521 DOI: 10.1016/j.rehab.2020.10.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 10/09/2020] [Accepted: 10/11/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although previous narrative reviews have highlighted a potential association between visuospatial neglect (VSN) and balance disorders, to what extent different areas of balance and mobility could be affected is still unclear. OBJECTIVES This systematic review updates previous literature findings and systematically reviews sitting balance, standing balance and mobility outcomes. METHODS PubMed, Web of Science, ScienceDirect, Naric-Rehabdata, PEDro and the Cochrane Trials Library were systematically searched. Methodological quality was assessed by the National Heart, Lung, and Blood Institute Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The association between VSN and sitting balance, standing balance and mobility (walking, stair climbing/descending and transfers) was investigated. RESULTS In total, 48 studies were included (4595 stroke survivors): at least 1319 (29%) showed symptoms of VSN. VSN was associated with less independence during sitting, with an asymmetric posture toward the affected body side. For standing balance, we revealed a significant negative association between VSN and mediolateral stability and weight shifting, whereas only activities of daily living-related VSN was associated with weight-bearing asymmetry during static stance. While walking, patients with VSN laterally deviated from their path. Results were inconclusive regarding other aspects of mobility. The association between VSN and balance/mobility seemed to decrease over time. CONCLUSIONS Despite great heterogeneity in results, this study suggests that stroke survivors with VSN show specific deviations in posture and movement in the mediolateral direction. Although the association between VSN and balance/mobility has been extensively investigated, explanatory studies evaluating underlying mechanisms of the frequently present association are lacking. Future studies should address this by combining clinical and instrumented assessment of balance and gait performance, preferably longitudinally to investigate the associations over time.
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Affiliation(s)
- Elissa Embrechts
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium.
| | - Tamaya Van Criekinge
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Jonas Schröder
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Tanja Nijboer
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands; Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Christophe Lafosse
- Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
| | - Steven Truijen
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Wim Saeys
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium; Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
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16
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Held JPO, Yu K, Pyles C, Veerbeek JM, Bork F, Heining SM, Navab N, Luft AR. Augmented Reality-Based Rehabilitation of Gait Impairments: Case Report. JMIR Mhealth Uhealth 2020; 8:e17804. [PMID: 32452815 PMCID: PMC7284394 DOI: 10.2196/17804] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/06/2020] [Accepted: 03/22/2020] [Indexed: 11/27/2022] Open
Abstract
Background Gait and balance impairments are common in neurological diseases, including stroke, and negatively affect patients’ quality of life. Improving balance and gait are among the main goals of rehabilitation. Rehabilitation is mainly performed in clinics, which lack context specificity; therefore, training in the patient’s home environment is preferable. In the last decade, developed rehabilitation technologies such as virtual reality and augmented reality (AR) have enabled gait and balance training outside clinics. Here, we propose a new method for gait rehabilitation in persons who have had a stroke in which mobile AR technology and a sensor-based motion capture system are combined to provide fine-grained feedback on gait performance in real time. Objective The aims of this study were (1) to investigate manipulation of the gait pattern of persons who have had a stroke based on virtual augmentation during overground walking compared to walking without AR performance feedback and (2) to investigate the usability of the AR system. Methods We developed the ARISE (Augmented Reality for gait Impairments after StrokE) system, in which we combined a development version of HoloLens 2 smart glasses (Microsoft Corporation) with a sensor-based motion capture system. One patient with chronic minor gait impairment poststroke completed clinical gait assessments and an AR parkour course with patient-centered performance gait feedback. The movement kinematics during gait as well as the usability and safety of the system were evaluated. Results The patient changed his gait pattern during AR parkour compared to the pattern observed during the clinical gait assessments. He recognized the virtual objects and ranked the usability of the ARISE system as excellent. In addition, the patient stated that the system would complement his standard gait therapy. Except for the symptom of exhilaration, no adverse events occurred. Conclusions This project provided the first evidence of gait adaptation during overground walking based on real-time feedback through visual and auditory augmentation. The system has potential to provide gait and balance rehabilitation outside the clinic. This initial investigation of AR rehabilitation may aid the development and investigation of new gait and balance therapies.
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Affiliation(s)
- Jeremia Philipp Oskar Held
- Division of Vascular Neurology and Neurorehabilitation, Department of Neurology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Kevin Yu
- University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Connor Pyles
- Johns Hopkins Applied Physics Laboratory, Johns Hopkins University, Laurel, MD, United States
| | - Janne Marieke Veerbeek
- Division of Vascular Neurology and Neurorehabilitation, Department of Neurology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Felix Bork
- Computer Aided Medical Procedures and Augmented Reality, Technical University of Munich, Munich, Germany
| | - Sandro-Michael Heining
- Department of Trauma Surgery, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Nassir Navab
- Computer Aided Medical Procedures and Augmented Reality, Technical University of Munich, Munich, Germany.,Computer Aided Medical Procedures, Johns Hopkins University, Baltimore, MD, United States
| | - Andreas Rüdiger Luft
- Division of Vascular Neurology and Neurorehabilitation, Department of Neurology, University of Zurich and University Hospital Zurich, Zurich, Switzerland.,cereneo Center for Neurology and Rehabilitation, Vitznau, Switzerland
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17
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Elliott DB, Black AA, Wood JM. Subjective Verticality Is Disrupted by Astigmatic Visual Distortion in Older People. Invest Ophthalmol Vis Sci 2020; 61:12. [PMID: 32293665 PMCID: PMC7401669 DOI: 10.1167/iovs.61.4.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Purpose There is little research evidence to explain why older adults have more problems adapting to new spectacles incorporating astigmatic changes than younger adults. We tested the hypothesis that astigmatic lenses oriented obliquely would lead to errors in verticality perception that are greater for older than younger adults. Methods Participants included 12 young (mean ± SD age 25.1 ± 5.0 years) and 12 older (70.2 ± 6.3 years) adults with normal vision. Verticality perception was assessed using a computer-based subjective visual vertical (SVV) task, under static and dynamic (in the presence of a moving peripheral distractor) conditions and when viewing targets through the near refractive correction (control condition), and two forms of astigmatic lenses oriented in the vertical, horizontal, and oblique meridians. Results The older group demonstrated much greater dynamic SVV errors (e.g., 3.4° for the control condition) than the younger group (1.2°, P = 0.002), larger errors with vertical and horizontal astigmatic lenses (older group 4.1°and 5.2° for toric and magnifier lenses vs. younger group 1.2° and 1.4°, respectively, P < 0.001), and a larger influence of the oblique astigmatic lenses (older group 5.6° vs. younger group 2.1°, P<0.001). Conclusions Astigmatic lenses produced little or no errors in SVV in young adults, but large static and dynamic SVV errors in older adults. This indicates a greater reliance on visual input with increased age for SVV, and helps explain why oblique astigmatic refractive corrections can cause dizziness in older patients and why they report greater difficulties adapting to new spectacles with astigmatic changes.
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18
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Jamal K, Leplaideur S, Rousseau C, Cordillet S, Raillon AM, Butet S, Cretual A, Bonan I. The effects of repetitive neck-muscle vibration on postural disturbances after a chronic stroke. Neurophysiol Clin 2020; 50:269-278. [PMID: 32245547 DOI: 10.1016/j.neucli.2020.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 01/22/2020] [Accepted: 01/22/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE We aimed to test a repeated program of vibration sessions of the neck muscles (rNMV) on postural disturbances and spatial perception in patients with right (RBD) versus left (LBD) vascular brain damage. METHODS Thirty-two chronic stroke patients (mean age 60.9±10 yrs and mean time since stroke 4.9±4 yrs), 16 RBD and 16 LBD, underwent a program of 10 sessions of NMV over two weeks. Posturography parameters (weight-bearing asymmetry (WBA), Xm, Ym, and surface), balance rating (Berg Balance Scale (BBS), Timed Up and Go (TUG)), space representation (subjective straight ahead (SSA), longitudinal body axis (LBA), subjective visual vertical (SVV)), and post-stroke deficiencies (motricity index, sensitivity, and spasticity) were tested and the data analyzed by ANOVA or a linear rank-based model, depending on whether the data were normally distributed, with lesion side and time factor (D-15, D0, D15, D21, D45). RESULTS The ANOVA revealed a significant interaction between lesion side and time for WBA (P<0.0001) with a significant shift towards the paretic lower limb in the RBD patients only (P=0.0001), whereas there was no effect in the LBD patients (P=0.98). Neither group showed a significant modification of spatial representation. Nonetheless, there was a significant improvement in motricity (P=0.02), TUG (P=0.0005), and BBS (P<0.0001) in both groups at the end of treatment and afterwards. CONCLUSIONS rNMV appeared to correct WBA in RBD patients only. This suggests that rNMV could be effective in treating sustainable imbalance due to spatial cognition disorders.
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Affiliation(s)
- Karim Jamal
- Physical and Rehabilitation Medicine Department, University Hospital of Rennes, Rennes, France; M2S laboratory-EA 1274, University of Rennes 2, Rennes, France.
| | - Stéphanie Leplaideur
- Physical and Rehabilitation Medicine Department, University Hospital of Rennes, Rennes, France; Neurology Physical and Rehabilitation Medicine Department, CMRRF KERPAPE, France; Unit EMPENN, INSERM, INRIA, Unit 1228 University Rennes 1, Rennes, France
| | - Chloé Rousseau
- Department of Clinical Pharmacology, Clinical Investigation, Center INSERM 1414, University Hospital of Rennes, Rennes, France
| | - Sébastien Cordillet
- Physical and Rehabilitation Medicine Department, University Hospital of Rennes, Rennes, France
| | - Annelise Moulinet Raillon
- Physical and Rehabilitation Medicine Department, University Hospital of Rennes, Rennes, France; Physical and rehabilitation medicine department, Hospital of Saint-Vallier, Saint-Vallier, France
| | - Simon Butet
- Physical and Rehabilitation Medicine Department, University Hospital of Rennes, Rennes, France
| | - Armel Cretual
- M2S laboratory-EA 1274, University of Rennes 2, Rennes, France
| | - Isabelle Bonan
- Physical and Rehabilitation Medicine Department, University Hospital of Rennes, Rennes, France; M2S laboratory-EA 1274, University of Rennes 2, Rennes, France
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19
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Bonuzzi GMG, de Freitas TB, Palma GCDS, Soares MAA, Lange B, Pompeu JE, Torriani-Pasin C. Effects of the brain-damaged side after stroke on the learning of a balance task in a non-immersive virtual reality environment. Physiother Theory Pract 2020; 38:28-35. [PMID: 32090670 DOI: 10.1080/09593985.2020.1731893] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Post-stroke survivors with right hemisphere injury have more impairments in postural control and balance. However, the impact of the hemisphere injured on the process of balance reacquisition has not been fully explored. We hypothesized that stroke survivors could learn balance tasks (H1), but right hemisphere damaged patients would show poor motor learning if compared to left hemisphere damaged patients (H2)Objective: To investigate whether the brain-damaged side after stroke affects the learning of a balance task. Methods: Three groups were recruited: twenty stroke survivors (ten left and ten right hemisphere damage) and twenty healthy volunteers. The participants practiced a balance task for thirty minutes, four consecutive days. The task was the Table Tilt game (NintendoTM Company), which induces balance demands with a progression of complexity. Motor performance was assessed at baseline, post-practice and after one week (retention test). Accuracy, errors, and complexity of the task achieved during the trial were assessedResults: Participants in all groups improved their performance (p < .001) and maintained it at the retention test. The control group showed better performance if compared to the right and left hemisphere damaged stroke survivors (p < .05). There was no difference between individuals with right and left hemisphere damaged, but the right hemisphere damaged patients demonstrated more errors at higher levels of complexityConclusion: Stroke survivors can learn balance tasks (H1), and the right hemisphere damaged patients demonstrate more errors than those with left hemisphere injury in higher complexity conditions (H2).
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Affiliation(s)
- Giordano Márcio Gatinho Bonuzzi
- Motor Behavior Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil.,Department of Physical Education, Piauí State University, Picos, Brazil
| | - Tatiana Beline de Freitas
- Motor Behavior Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | | | | | - Belinda Lange
- College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
| | - José Eduardo Pompeu
- Department of Physical Therapy, Speech Therapy and Occupational Therapy, University of São Paulo, São Paulo, Brazil
| | - Camila Torriani-Pasin
- Motor Behavior Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
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Mori K, Nakamura K, Hashimoto S, Wakida M, Hase K. Novel characterization of subjective visual vertical in patients with unilateral spatial neglect. Neurosci Res 2020; 163:18-25. [PMID: 32084447 DOI: 10.1016/j.neures.2020.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 01/24/2020] [Accepted: 02/18/2020] [Indexed: 10/25/2022]
Abstract
Visual vertical (VV), visually perceived direction of gravity, is widely measured to assess the vestibular function and visuospatial cognition. VV has been assessed by comparing orientation and variability of measured values separately between subject groups. However, changes in orientation and variability often differ in patients with unilateral spatial neglect (USN). Here, we developed a novel classification of VV that combines orientation and variability and characterized the effects of USN on VV. Forty-three subacute stroke patients with or without USN (USN+, n = 17; USN-, n = 26) and 33 age-matched controls were included in the study. In darkness, a luminous line, initially tilted at 30° either to the left or right, gradually rotated towards the vertical. The VV was defined as the deviation of the subjectively-perceived vertical from the true vertical. The new classification demonstrated that, while the majority of USN + patients (14/17) exhibited large variability, nine showed normal orientation and five showed greater contra-lesional deviation of orientation, suggesting different underlying mechanisms for orientation and variability. Further analyses revealed VV deviation to the initial tilt in all groups. However, the deviation in USN + was larger and more variable, indicating attentional disorders. Such characterization would contribute to individually specified clinical rehabilitation.
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Affiliation(s)
- Kimihiko Mori
- Department of Physical Medicine and Rehabilitation, Kansai Medical University Hospital, 2-3-1 Shinmachi, Hirakata, Osaka 573-1191, Japan; Department of Physiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka 573-1010, Japan.
| | - Kae Nakamura
- Department of Physiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka 573-1010, Japan
| | - Shingo Hashimoto
- Department of Physical Medicine and Rehabilitation, Kansai Medical University Hospital, 2-3-1 Shinmachi, Hirakata, Osaka 573-1191, Japan
| | - Masanori Wakida
- Department of Physical Medicine and Rehabilitation, Kansai Medical University Kori Hospital, 8-45 Korihondoricho, Neyagawa, Osaka 572-8551, Japan
| | - Kimitaka Hase
- Department of Physical Medicine and Rehabilitation, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka 573-1010, Japan
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21
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Influence of unilateral spatial neglect on vertical perception in post-stroke pusher behavior. Neurosci Lett 2020; 715:134667. [DOI: 10.1016/j.neulet.2019.134667] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/23/2019] [Accepted: 11/30/2019] [Indexed: 11/19/2022]
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22
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Tani K, Ishimaru S, Yamamoto S, Kodaka Y, Kushiro K. Effect of dynamic visual motion on perception of postural vertical through the modulation of prior knowledge of gravity. Neurosci Lett 2019; 716:134687. [PMID: 31838018 DOI: 10.1016/j.neulet.2019.134687] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 12/07/2019] [Accepted: 12/11/2019] [Indexed: 11/24/2022]
Abstract
To internally estimate gravitational direction and body orientation, the central nervous system considers several sensory inputs from the periphery and prior knowledge of gravity. It is hypothesized that the modulation of visual inputs, supplying indirect information of gravity, affects the prior knowledge established internally by other sensory inputs from vestibular and somatosensory systems, leading to the alteration of perceived body orientation relative to gravity. In order to test the hypothesis, we examined the effect of presenting a visual motion stimulus during a whole-body static tilt on the subsequent evaluation of the perceived postural vertical. Fifteen subjects watched a target moving along the body longitudinal axis directing from head to feet with constant downward acceleration (CA condition) or constant velocity (CV condition), or they did not receive any visual stimulation (NV condition) during the whole-body static tilt. Subsequently, the direction of the subjective postural vertical (SPV) was evaluated. The result showed that the SPV in the CA condition was significantly tilted toward the direction of the preceding tilt compared to that in the NV condition while those in the CV and NV conditions were not significantly different. The present result suggests that dynamic visual motion along body longitudinal axis with downward acceleration can modulate prior knowledge of gravity, and in turn this affects the perception of body verticality.
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Affiliation(s)
- Keisuke Tani
- Laboratory of Psychology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan.
| | - Sho Ishimaru
- Faculty of Integrated Human Studies, Kyoto University, Yoshida-nihonmatsu-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
| | - Shinji Yamamoto
- Faculty of Sport Sciences, Nihon Fukushi University, Okuda, Mihama-cho, Chita-gun, Aichi, 470-3295, Japan.
| | - Yasushi Kodaka
- National Institute of Advanced Industrial Science and Technology (AIST), Automotive Human Factors Research Center, 1-1-1 Umezono, Tsukuba, Ibaraki, 305-8568, Japan.
| | - Keisuke Kushiro
- Faculty of Integrated Human Studies, Kyoto University, Yoshida-nihonmatsu-cho, Sakyo-ku, Kyoto, 606-8501, Japan; Graduate School of Human and Environmental Studies, Kyoto University, Yoshida-nihonmatsu-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
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23
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Abstract
PURPOSE OF REVIEW Disorders of posture and balance cause significant patient morbidity, with reduction of quality of life as patients refrain from critical activities of daily living such as walking outside the home and driving. This review describes recent efforts to characterize visual disorders that interact with the neural integrators of positional maintenance and emerging therapies for these disorders. RECENT FINDINGS Abnormalities of gait and body position sense may be unrecognized by patients but are correlated with focal neurological injury (stroke). Patients with traumatic brain injury can exhibit visual vertigo despite otherwise normal visual functioning. The effect of visual neglect on posture and balance, even in the absence of a demonstrable visual field defect, has been characterized quantitatively through gait analysis and validates the potential therapeutic value of prism treatment in some patients. In addition, the underlying neural dysfunction in visual vertigo has been explored further using functional imaging, and these observations may allow discrimination of patients with structural causes from those whose co-morbid psychosocial disorders may be primarily contributory.
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Affiliation(s)
- Jeffrey R Hebert
- Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO, 80045, USA.,Department of Neurology, University of Colorado School of Medicine, Aurora, CO, 80045, USA.,Marcus Institute for Brain Health, University of Colorado School of Medicine, Aurora, CO, 80045, USA
| | - Prem S Subramanian
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, 80045, USA. .,Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, 80045, USA. .,Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, 80045, USA. .,Sue Anschutz-Rodgers UCHealth Eye Center, 1675 Aurora Ct Mail Stop F731, Aurora, CO, 80045, USA.
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24
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Le Berre M, Pradeau C, Brouillard A, Coget M, Massot C, Catanzariti JF. Do Adolescents With Idiopathic Scoliosis Have an Erroneous Perception of the Gravitational Vertical? Spine Deform 2019; 7:71-79. [PMID: 30587324 DOI: 10.1016/j.jspd.2018.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 04/28/2018] [Accepted: 05/05/2018] [Indexed: 10/27/2022]
Abstract
STUDY DESIGN Multicenter, case-control study. OBJECTIVES Demonstrate altered perception of verticality in AIS compared with matched controls. SUMMARY OF BACKGROUND DATA The cause of adolescent idiopathic scoliosis (AIS) remains to be found. AIS is associated with neurosensorial anomalies, in particular, altered control of orthostatic posture. During kinetic activity, the upright posture, in humans, is determined in reference to the gravitational vertical (GV). We hypothesized that in AIS, there is a discordance in the perception of the GV and the true GV. In AIS, the longitudinal axis of the body would thus be misoriented because of an erroneous perception of the GV. METHODS Thirty adolescents with right thoracic AIS (age 14.23 ± 1.75 years; Cobb angle 31.97°± 12.83°) and 30 controls matched for age (13.93 ± 1.85 years), body mass index, Tanner stage, and handedness were compared for subjective visual vertical (SVV) measured in static and dynamic (optokinetic stimulation) conditions, and subjective postural vertical (SPV). RESULTS There was no difference in the two groups, AIS and controls, for SVV. The SPV was significantly different between the two groups (p = .00023). The SPV was shifted to the right for most of the AIS patients (2.13°± 2.22°) compared with controls (-0.08°±1.40°). There was a significant correlation between SPV and clinical frontal tilt in the AIS patients. CONCLUSION Our findings demonstrate that patients with right thoracic AIS have an erroneous perception of the GV. In most AIS patients, SPV was shifted to the right, with no alteration of the SVV. AIS might be the consequence of a reoriented longitudinal body axis aligned with an erroneous vertical reference. The underlying mechanism might involve dysfunction of trunk graviceptors. The primary or secondary nature of this dysfunction remains an open question.
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Affiliation(s)
- Morgane Le Berre
- Physical Medicine and Rehabilitation Department, Swynghedauw University Hospital Center, Lille, France
| | - Charles Pradeau
- Physical Medicine and Rehabilitation Department, Swynghedauw University Hospital Center, Lille, France
| | | | - Monique Coget
- Spine department, SSR pediatric center Marc Sautelet, Villeneuve-d'Ascq, France
| | - Caroline Massot
- Physical Medicine and Rehabilitation Department, Saint Philibert University Hospital Center, Lomme 59462, France
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25
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Santos TEG, Favoretto DB, Toostani IG, Nascimento DC, Rimoli BP, Bergonzoni E, Lemos TW, Truong DQ, Delbem ACB, Makkiabadi B, Moraes R, Louzada F, Bikson M, Leite JP, Edwards DJ. Manipulation of Human Verticality Using High-Definition Transcranial Direct Current Stimulation. Front Neurol 2018; 9:825. [PMID: 30459697 PMCID: PMC6232937 DOI: 10.3389/fneur.2018.00825] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 09/12/2018] [Indexed: 01/27/2023] Open
Abstract
Background: Using conventional tDCS over the temporo-parietal junction (TPJ) we previously reported that it is possible to manipulate subjective visual vertical (SVV) and postural control. We also demonstrated that high-definition tDCS (HD-tDCS) can achieve substantially greater cortical stimulation focality than conventional tDCS. However, it is critical to establish dose-response effects using well-defined protocols with relevance to clinically meaningful applications. Objective: To conduct three pilot studies investigating polarity and intensity-dependent effects of HD-tDCS over the right TPJ on behavioral and physiological outcome measures in healthy subjects. We additionally aimed to establish the feasibility, safety, and tolerability of this stimulation protocol. Methods: We designed three separate randomized, double-blind, crossover phase I clinical trials in different cohorts of healthy adults using the same stimulation protocol. The primary outcome measure for trial 1 was SVV; trial 2, weight-bearing asymmetry (WBA); and trial 3, electroencephalography power spectral density (EEG-PSD). The HD-tDCS montage comprised a single central, and 3 surround electrodes (HD-tDCS3x1) over the right TPJ. For each study, we tested 3x2 min HD-tDCS3x1 at 1, 2 and 3 mA; with anode center, cathode center, or sham stimulation, in random order across days. Results: We found significant SVV deviation relative to baseline, specific to the cathode center condition, with consistent direction and increasing with stimulation intensity. We further showed significant WBA with direction governed by stimulation polarity (cathode center, left asymmetry; anode center, right asymmetry). EEG-PSD in the gamma band was significantly increased at 3 mA under the cathode. Conclusions: The present series of studies provide converging evidence for focal neuromodulation that can modify physiology and have behavioral consequences with clinical potential.
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Affiliation(s)
- Taiza E G Santos
- Department of Neuroscience and Behavioral Sciences, Ribeirao Preto Medical School University of Sao Paulo, Ribeirão Preto, Brazil
| | - Diandra B Favoretto
- Department of Neuroscience and Behavioral Sciences, Ribeirao Preto Medical School University of Sao Paulo, Ribeirão Preto, Brazil
| | - Iman Ghodratti Toostani
- Neurocognitive Engineering Laboratory, Center of Engineering Applied to Health University of São Paulo, São Carlos, Brazil.,Reconfigurable Computing Laboratory, Institute of Mathematics and Computer Sciences University of São Paulo, São Carlos, Brazil
| | - Diego C Nascimento
- Department of Applied Mathematics and Statistics, Institute of Mathematics and Computer Sciences University of São Paulo, São Carlos, Brazil
| | - Brunna P Rimoli
- Department of Neuroscience and Behavioral Sciences, Ribeirao Preto Medical School University of Sao Paulo, Ribeirão Preto, Brazil
| | - Eduardo Bergonzoni
- Department of Neuroscience and Behavioral Sciences, Ribeirao Preto Medical School University of Sao Paulo, Ribeirão Preto, Brazil
| | - Tenysson Will Lemos
- School of Physical Education and Sport of Ribeirao Preto University of São Paulo, Ribeirao Preto, Brazil
| | - Dennis Q Truong
- Neural Engineering Laboratory, Department of Biomedical Engineering, The City College of New York, City University of New York New York, NY, United States
| | - Alexandre C B Delbem
- Neurocognitive Engineering Laboratory, Center of Engineering Applied to Health University of São Paulo, São Carlos, Brazil.,Reconfigurable Computing Laboratory, Institute of Mathematics and Computer Sciences University of São Paulo, São Carlos, Brazil
| | - Bahador Makkiabadi
- Department of Medical Physics and Biomedical Engineering, School of Medicine Tehran University of Medical Sciences (TUMS), Tehran, Iran.,Research Center for Biomedical Technology and Robotics (RCBTR), Institute of Advanced Medical Technologies (IAMT) Tehran University of Medical Sciences, Tehran, Iran
| | - Renato Moraes
- School of Physical Education and Sport of Ribeirao Preto University of São Paulo, Ribeirao Preto, Brazil
| | - Francisco Louzada
- Department of Applied Mathematics and Statistics, Institute of Mathematics and Computer Sciences University of São Paulo, São Carlos, Brazil
| | - Marom Bikson
- Neural Engineering Laboratory, Department of Biomedical Engineering, The City College of New York, City University of New York New York, NY, United States
| | - Joao P Leite
- Department of Neuroscience and Behavioral Sciences, Ribeirao Preto Medical School University of Sao Paulo, Ribeirão Preto, Brazil
| | - Dylan J Edwards
- Moss Rehabilitation Research Institute Elkins Park, PA, United States.,School of Medical and Health Sciences, Edith Cowan University Joondalup, WA, Australia
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26
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Fujita T, Sato A, Iokawa K, Yamane K, Yamamoto Y, Tsuchiya K, Ohira Y, Otsuki K. A path analysis model for grooming performance in stroke patients. Disabil Rehabil 2018; 41:2958-2964. [DOI: 10.1080/09638288.2018.1483431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Takaaki Fujita
- Department of Rehabilitation, Faculty of Health Sciences, Tohoku Fukushi University, Sendai, Japan
| | - Atsushi Sato
- The Database Center of the National University Hospitals, University of Tokyo Hospital, Bunkyo-ku, Japan
| | - Kazuaki Iokawa
- Preparing Section for New Faculty of Medical Science, Fukushima Medical University, Fukushima, Japan
| | - Kazuhiro Yamane
- Department of Rehabilitation, Kita-Fukushima Medical Center, Date, Japan
| | - Yuichi Yamamoto
- Department of Rehabilitation, Kita-Fukushima Medical Center, Date, Japan
| | - Kenji Tsuchiya
- Department of Rehabilitation Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Japan
| | - Yoko Ohira
- Department of Rehabilitation, Kita-Fukushima Medical Center, Date, Japan
| | - Koji Otsuki
- Department of Rehabilitation, Kita-Fukushima Medical Center, Date, Japan
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27
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Disturbances of spatial reference frame and postural asymmetry after a chronic stroke. Exp Brain Res 2018; 236:2377-2385. [DOI: 10.1007/s00221-018-5308-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 06/05/2018] [Indexed: 01/24/2023]
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28
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Negrillo-Cárdenas J, Rueda-Ruiz AJ, Ogayar-Anguita CJ, Lomas-Vega R, Segura-Sánchez RJ. A System for the Measurement of the Subjective Visual Vertical using a Virtual Reality Device. J Med Syst 2018; 42:124. [DOI: 10.1007/s10916-018-0981-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 05/18/2018] [Indexed: 10/14/2022]
Affiliation(s)
- José Negrillo-Cárdenas
- Department of Computer Science, University of Jaén, Campus Las Lagunillas s/n, A3 building, 23071, Jaén, Spain.
| | - Antonio J Rueda-Ruiz
- Department of Computer Science, University of Jaén, Campus Las Lagunillas s/n, A3 building, 23071, Jaén, Spain
| | - Carlos J Ogayar-Anguita
- Department of Computer Science, University of Jaén, Campus Las Lagunillas s/n, A3 building, 23071, Jaén, Spain
| | | | - Rafael J Segura-Sánchez
- Department of Computer Science, University of Jaén, Campus Las Lagunillas s/n, A3 building, 23071, Jaén, Spain
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29
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Schindlbeck KA, Naumann W, Maier A, Ehlen F, Marzinzik F, Klostermann F. Disturbance of verticality perception and postural dysfunction in Parkinson's disease. Acta Neurol Scand 2018; 137:212-217. [PMID: 29063605 DOI: 10.1111/ane.12859] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2017] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Verticality perception is known to be abnormal in Parkinson's disease (PD), but in which stage respective dysfunctions arise and how they relate to postural disorders remains to be settled. These issues were studied with respect to different dimensions of the subjective visual vertical (SVV) in relation to clinical parameters of postural control. MATERIALS & METHODS All participants had to orientate a luminous line at random planar orientations to a strictly vertical position using an automated operator system. The SVV was analyzed in 58 PD patients and 28 control subjects with respect to (i) the angle between true and subjective vertical (deviation) and (ii) the variability of this across five measurements (variability). Results were referred to the subjective upright head position (SUH), the disease stage, and clinical gait/balance features assessed by the MDS-UPDRS and the Tinetti test. RESULTS Parkinson's disease patients had significantly higher SVV deviation and variability than controls. With respect to disease stage, deviation developed before abnormal variability. SVV variability was associated with poor balance and gait performance, as well as postural instability. Deficits in SUH and SVV deviation were correlated and mostly unidirectional, but did not correspond to the side of motor symptom dominance. CONCLUSIONS Visual verticality perception in PD is deviated already in early stages, conceivably as a relatively static internal misrepresentation of object orientation. Variability about verticality perception emerges in more advanced stages and is associated with postural and balance abnormalities.
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Affiliation(s)
- K. A. Schindlbeck
- Department of Neurology Charité – Universitätsmedizin Berlin Berlin Germany
| | - W. Naumann
- Department of Neurology Charité – Universitätsmedizin Berlin Berlin Germany
| | - A. Maier
- Department of Neurology Charité – Universitätsmedizin Berlin Berlin Germany
| | - F. Ehlen
- Department of Neurology Charité – Universitätsmedizin Berlin Berlin Germany
| | - F. Marzinzik
- Department of Neurology Charité – Universitätsmedizin Berlin Berlin Germany
| | - F. Klostermann
- Department of Neurology Charité – Universitätsmedizin Berlin Berlin Germany
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30
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Fukata K, Amimoto K, Fujino Y, Inoue M, Inoue M, Takahashi Y, Makita S, Takahashi H. The effects of aging on the subjective vertical in the frontal plane in healthy adults. J Phys Ther Sci 2017; 29:1950-1953. [PMID: 29200631 PMCID: PMC5702821 DOI: 10.1589/jpts.29.1950] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 08/09/2017] [Indexed: 11/26/2022] Open
Abstract
[Purpose] To determine age-related differences in the subjective vertical in the frontal
plane in healthy adults. [Subjects and Methods] The subjects were 26 healthy adults. For
the subjective visual vertical (SVV), subjects were presented with a visual indicator in
front of them that was rotated. For the subjective postural vertical-eyes open (SPV-EO)
and subjective postural vertical (SPV), subjects sat in a seating device that was tilted
right or left. The subjects gave a signal when they perceived true verticality. Each task
was performed eight times. The items examined were the mean (tilt direction) and standard
deviation (variability) of the eight trials, then the mean of four trials that started
from the right or left side position. These items were compared between the young (age:
22–30 years [range]) and elderly (age: 60–74 years) groups. [Results] As for variability,
the elderly group demonstrated significantly higher values of SPV-EO and SPV. As for the
starting point effect, the elderly group demonstrated greater bias toward the starting
direction than did the young group in SPV-EO and SPV in frontal plane. [Conclusion] The
postural vertical was shown to change with age. Consideration of age-related changes and
the starting point effect was indicated to be important.
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Affiliation(s)
- Kazuhiro Fukata
- Department of Rehabilitation Center, Saitama Medical University International Medical Center: 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan.,Department of Physical Therapy, Tokyo Metropolitan University, Japan
| | - Kazu Amimoto
- Department of Physical Therapy, Tokyo Metropolitan University, Japan
| | - Yuji Fujino
- Department of Rehabilitation Center, Saitama Medical University International Medical Center: 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Masahide Inoue
- Department of Rehabilitation Center, Saitama Medical University International Medical Center: 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Mamiko Inoue
- Department of Rehabilitation Center, Saitama Medical University International Medical Center: 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Yosuke Takahashi
- Department of Rehabilitation Center, Saitama Medical University International Medical Center: 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Shigeru Makita
- Department of Rehabilitation, Saitama Medical University International Medical Center, Japan
| | - Hidetoshi Takahashi
- Department of Rehabilitation, Saitama Medical University International Medical Center, Japan
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31
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Kheradmand A, Winnick A. Perception of Upright: Multisensory Convergence and the Role of Temporo-Parietal Cortex. Front Neurol 2017; 8:552. [PMID: 29118736 PMCID: PMC5660972 DOI: 10.3389/fneur.2017.00552] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 09/28/2017] [Indexed: 12/18/2022] Open
Abstract
We inherently maintain a stable perception of the world despite frequent changes in the head, eye, and body positions. Such "orientation constancy" is a prerequisite for coherent spatial perception and sensorimotor planning. As a multimodal sensory reference, perception of upright represents neural processes that subserve orientation constancy through integration of sensory information encoding the eye, head, and body positions. Although perception of upright is distinct from perception of body orientation, they share similar neural substrates within the cerebral cortical networks involved in perception of spatial orientation. These cortical networks, mainly within the temporo-parietal junction, are crucial for multisensory processing and integration that generate sensory reference frames for coherent perception of self-position and extrapersonal space transformations. In this review, we focus on these neural mechanisms and discuss (i) neurobehavioral aspects of orientation constancy, (ii) sensory models that address the neurophysiology underlying perception of upright, and (iii) the current evidence for the role of cerebral cortex in perception of upright and orientation constancy, including findings from the neurological disorders that affect cortical function.
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Affiliation(s)
- Amir Kheradmand
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Department of Otolaryngology – Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Ariel Winnick
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
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32
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Chang YT, Meng LF, Chang CJ, Lai PL, Lung CW, Chern JS. Effect of Postural Control Demands on Early Visual Evoked Potentials during a Subjective Visual Vertical Perception Task in Adolescents with Idiopathic Scoliosis. Front Hum Neurosci 2017; 11:326. [PMID: 28713252 PMCID: PMC5492482 DOI: 10.3389/fnhum.2017.00326] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 06/06/2017] [Indexed: 11/23/2022] Open
Abstract
Subjective visual vertical (SVV) judgment and standing stability were separately investigated among patients with adolescent idiopathic scoliosis (AIS). Although, one study has investigated the central mechanism of stability control in the AIS population, the relationships between SVV, decreased standing stability, and AIS have never been investigated. Through event-related potentials (ERPs), the present study examined the effect of postural control demands (PDs) on AIS central mechanisms related to SVV judgment and standing stability to elucidate the time-serial stability control process. Thirteen AIS subjects (AIS group) and 13 age-matched adolescents (control group) aged 12–18 years were recruited. Each subject had to complete an SVV task (i.e., the modified rod-and-frame [mRAF] test) as a stimulus, with online electroencephalogram recording being performed in the following three standing postures: feet shoulder-width apart standing, feet together standing, and tandem standing. The behavioral performance in terms of postural stability (center of pressure excursion), SVV (accuracy and reaction time), and mRAF-locked ERPs (mean amplitude and peak latency of the P1, N1, and P2 components) was then compared between the AIS and control groups. In the behavioral domain, the results revealed that only the AIS group demonstrated a significantly accelerated SVV reaction time as the PDs increased. In the cerebral domain, significantly larger P2 mean amplitudes were observed during both feet shoulder-width-apart standing and feet together standing postures compared with during tandem standing. No group differences were noted in the cerebral domain. The results indicated that (1) during the dual-task paradigm, a differential behavioral strategy of accelerated SVV reaction time was observed in the AIS group only when the PDs increased and (2) the decrease in P2 mean amplitudes with the increase in the PD levels might be direct evidence of the competition for central processing attentional resources under the dual-task postural control paradigm.
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Affiliation(s)
- Yi-Tzu Chang
- Department of Educational Psychology and Counseling, National Taiwan Normal UniversityTaipei, Taiwan.,Department of Occupational Therapy and Graduate Institute of Behavioral Science, School of Medicine, Chang Gung UniversityTaoyuan, Taiwan
| | - Ling-Fu Meng
- Department of Occupational Therapy and Graduate Institute of Behavioral Science, School of Medicine, Chang Gung UniversityTaoyuan, Taiwan.,Division of Occupational Therapy, Department of Rehabilitation, Chiayi Chang Gung Memorial HospitalChiayi, Taiwan
| | - Chun-Ju Chang
- Graduate Institute of Medical Sciences, Chang Jung Christian UniversityTainan, Taiwan.,Department of Medical Science Industry, Chang Jung Christian UniversityTainan, Taiwan
| | - Po-Liang Lai
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Jung UniversityTaoyuan, Taiwan
| | - Chi-Wen Lung
- Department of Creative Product Design, Asia UniversityTaichung, Taiwan
| | - Jen-Suh Chern
- Graduate Institute of Rehabilitation Counseling, National Taiwan Normal UniversityTaipei, Taiwan
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33
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Dupuy EG, Leconte P, Vlamynck E, Sultan A, Chesneau C, Denise P, Besnard S, Bienvenu B, Decker LM. Ehlers-Danlos Syndrome, Hypermobility Type: Impact of Somatosensory Orthoses on Postural Control (A Pilot Study). Front Hum Neurosci 2017. [PMID: 28642694 PMCID: PMC5462950 DOI: 10.3389/fnhum.2017.00283] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Elhers-Danlos syndrome (EDS) is the clinical manifestation of connective tissue disorders, and comprises several clinical forms with no specific symptoms and selective medical examinations which result in a delay in diagnosis of about 10 years. The EDS hypermobility type (hEDS) is characterized by generalized joint hypermobility, variable skin hyperextensibility and impaired proprioception. Since somatosensory processing and multisensory integration are crucial for both perception and action, we put forth the hypothesis that somatosensory deficits in hEDS patients may lead, among other clinical symptoms, to misperception of verticality and postural instability. Therefore, the purpose of this study was twofold: (i) to assess the impact of somatosensory deficit on subjective visual vertical (SVV) and postural stability; and (ii) to quantify the effect of wearing somatosensory orthoses (i.e., compressive garments and insoles) on postural stability. Six hEDS patients and six age- and gender-matched controls underwent a SVV (sitting, standing, lying on the right side) evaluation and a postural control evaluation on a force platform (Synapsys), with or without visual information (eyes open (EO)/eyes closed (EC)). These two latter conditions performed either without orthoses, or with compression garments (CG), or insoles, or both. Results showed that patients did not exhibit a substantial perceived tilt of the visual vertical in the direction of the body tilt (Aubert effect) as did the control subjects. Interestingly, such differential effects were only apparent when the rod was initially positioned to the left of the vertical axis (opposite the longitudinal body axis). In addition, patients showed greater postural instability (sway area) than the controls. The removal of vision exacerbated this instability, especially in the mediolateral (ML) direction. The wearing of orthoses improved postural stability, especially in the eyes-closed condition, with a particularly marked effect in the anteroposterior (AP) direction. Hence, this study suggests that hEDS is associated with changes in the relative contributions of somatosensory and vestibular inputs to verticality perception. Moreover, postural control impairment was offset, at least partially, by wearing somatosensory orthoses.
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Affiliation(s)
- Emma G Dupuy
- COMETE, INSERM, UNICAEN, Normandie UniversitéCaen, France
| | | | | | - Audrey Sultan
- COMETE, INSERM, UNICAEN, Normandie UniversitéCaen, France.,Department of Internal Medicine, University Hospital Center of Caen, UNICAEN, Normandie UniversitéCaen, France
| | | | - Pierre Denise
- COMETE, INSERM, UNICAEN, Normandie UniversitéCaen, France
| | | | - Boris Bienvenu
- COMETE, INSERM, UNICAEN, Normandie UniversitéCaen, France.,Department of Internal Medicine, University Hospital Center of Caen, UNICAEN, Normandie UniversitéCaen, France
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Visual verticality perception after stroke: A systematic review of methodological approaches and suggestions for standardization. Ann Phys Rehabil Med 2017; 60:208-216. [PMID: 27079584 DOI: 10.1016/j.rehab.2016.02.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 02/03/2016] [Accepted: 02/07/2016] [Indexed: 11/22/2022]
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da Fonseca BAV, Pereira CB, Jorge F, Simm R, Apostolos-Pereira S, Callegaro D. A disturbed processing of graviceptive pathways may be involved in the pathophysiology of balance disorders in patients with multiple sclerosis. ARQUIVOS DE NEURO-PSIQUIATRIA 2016; 74:106-11. [PMID: 26982986 DOI: 10.1590/0004-282x20160004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 10/09/2015] [Indexed: 11/21/2022]
Abstract
The purpose of this study was to determine the relationship between perception of verticality and balance disorders in multiple sclerosis patients. We evaluated patients and healthy controls. Patients were divided into two groups according to their risk of fall, with or without risk of fall, measured by a Dynamic Gait Index scale. Graviceptive perception was assessed using the subjective visual vertical test. Patients with risk of fall showed worse perception than those without risk of fall, p < 0.001. Misperception of verticality was correlated with the dynamic gait index scores (p < 0.001), suggesting that the larger the error for verticality judgment, the greater risk for falling. Considering that the perception of verticality is essential for postural control, our results suggested that the disturbed processing of graviceptive pathways may be involved in the pathophysiology of balance disorders in these patients.
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Affiliation(s)
| | | | - Frederico Jorge
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Renata Simm
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | | | - Dagoberto Callegaro
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
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Barra J, Senot P, Auclair L. Internal model of gravity influences configural body processing. Cognition 2016; 158:208-214. [PMID: 27842273 DOI: 10.1016/j.cognition.2016.10.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 10/18/2016] [Accepted: 10/27/2016] [Indexed: 11/24/2022]
Abstract
Human bodies are processed by a configural processing mechanism. Evidence supporting this claim is the body inversion effect, in which inversion impairs recognition of bodies more than other objects. Biomechanical configuration, as well as both visual and embodied expertise, has been demonstrated to play an important role in this effect. Nevertheless, the important factor of body inversion effect may also be linked to gravity orientation since gravity is one of the most fundamental constraints of our biology, behavior, and perception on Earth. The visual presentation of an inverted body in a typical body inversion paradigm turns the observed body upside down but also inverts the implicit direction of visual gravity in the scene. The orientation of visual gravity is then in conflict with the direction of actual gravity and may influence configural processing. To test this hypothesis, we dissociated the orientations of the body and of visual gravity by manipulating body posture. In a pretest we showed that it was possible to turn an avatar upside down (inversion relative to retinal coordinates) without inverting the orientation of visual gravity when the avatar stands on his/her hands. We compared the inversion effect in typical conditions (with gravity conflict when the avatar is upside down) to the inversion effect in conditions with no conflict between visual and physical gravity. The results of our experiment revealed that the inversion effect, as measured by both error rate and reaction time, was strongly reduced when there was no gravity conflict. Our results suggest that when an observed body is upside down (inversion relative to participants' retinal coordinates) but the orientation of visual gravity is not, configural processing of bodies might still be possible. In this paper, we discuss the implications of an internal model of gravity in the configural processing of observed bodies.
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Affiliation(s)
- Julien Barra
- Laboratoire Vision Action Cognition EA7326, Institut de Psychologie, Université Paris Descartes, France; Laboratoire de Psychologie et NeuroCognition (UMR 5105), Université de Savoie Mont Blanc, F-7300 Chambéry, France.
| | - Patrice Senot
- Laboratoire Vision Action Cognition EA7326, Institut de Psychologie, Université Paris Descartes, France
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Reinhart S, Schaadt A, Keller I, Hildebrandt H, Kerkhoff G, Utz K. Rotational coherent dot movement normalizes spatial disorientation of the subjective visual vertical in patients with rightsided stroke. Neuropsychologia 2016; 92:174-180. [DOI: 10.1016/j.neuropsychologia.2016.04.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 04/26/2016] [Accepted: 04/29/2016] [Indexed: 10/21/2022]
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Santos-Pontelli TEG, Rimoli BP, Favoretto DB, Mazin SC, Truong DQ, Leite JP, Pontes-Neto OM, Babyar SR, Reding M, Bikson M, Edwards DJ. Polarity-Dependent Misperception of Subjective Visual Vertical during and after Transcranial Direct Current Stimulation (tDCS). PLoS One 2016; 11:e0152331. [PMID: 27031726 PMCID: PMC4816520 DOI: 10.1371/journal.pone.0152331] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 03/11/2016] [Indexed: 11/21/2022] Open
Abstract
Pathologic tilt of subjective visual vertical (SVV) frequently has adverse functional consequences for patients with stroke and vestibular disorders. Repetitive transcranial magnetic stimulation (rTMS) of the supramarginal gyrus can produce a transitory tilt on SVV in healthy subjects. However, the effect of transcranial direct current stimulation (tDCS) on SVV has never been systematically studied. We investigated whether bilateral tDCS over the temporal-parietal region could result in both online and offline SVV misperception in healthy subjects. In a randomized, sham-controlled, single-blind crossover pilot study, thirteen healthy subjects performed tests of SVV before, during and after the tDCS applied over the temporal-parietal region in three conditions used on different days: right anode/left cathode; right cathode/left anode; and sham. Subjects were blind to the tDCS conditions. Montage-specific current flow patterns were investigated using computational models. SVV was significantly displaced towards the anode during both active stimulation conditions when compared to sham condition. Immediately after both active conditions, there were rebound effects. Longer lasting after-effects towards the anode occurred only in the right cathode/left anode condition. Current flow models predicted the stimulation of temporal-parietal regions under the electrodes and deep clusters in the posterior limb of the internal capsule. The present findings indicate that tDCS over the temporal-parietal region can significantly alter human SVV perception. This tDCS approach may be a potential clinical tool for the treatment of SVV misperception in neurological patients.
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Affiliation(s)
- Taiza E G Santos-Pontelli
- Department of Neuroscience and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Brunna P Rimoli
- Department of Neuroscience and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Diandra B Favoretto
- Department of Neuroscience and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Suleimy C Mazin
- Department of Neuroscience and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Dennis Q Truong
- Neural Engineering Laboratory, Department of Biomedical Engineering, The City College of New York of the City University of New York, New York, New York, United States of America
| | - Joao P Leite
- Department of Neuroscience and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Octavio M Pontes-Neto
- Department of Neuroscience and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Suzanne R Babyar
- Non-invasive Brain Stimulation and Human Motor Control Laboratory, Burke Medical Research Institute, White Plains, New York, United States of America; Neurology Department, Weill Medical College, Cornell University, New York, New York, United States of America
| | - Michael Reding
- Non-invasive Brain Stimulation and Human Motor Control Laboratory, Burke Medical Research Institute, White Plains, New York, United States of America; Neurology Department, Weill Medical College, Cornell University, New York, New York, United States of America
| | - Marom Bikson
- Neural Engineering Laboratory, Department of Biomedical Engineering, The City College of New York of the City University of New York, New York, New York, United States of America
| | - Dylan J Edwards
- Non-invasive Brain Stimulation and Human Motor Control Laboratory, Burke Medical Research Institute, White Plains, New York, United States of America; Neurology Department, Weill Medical College, Cornell University, New York, New York, United States of America
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Fujita T, Nagayama H, Sato A, Yamamoto Y, Yamane K, Otsuki K, Tsuchiya K, Tozato F. Hierarchy of Dysfunction Related to Dressing Performance in Stroke Patients: A Path Analysis Study. PLoS One 2016; 11:e0151162. [PMID: 26954499 PMCID: PMC4783045 DOI: 10.1371/journal.pone.0151162] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 02/24/2016] [Indexed: 11/30/2022] Open
Abstract
Previous reports indicated that various dysfunctions caused by stroke affect the level of independence in dressing. These dysfunctions can be hierarchical, and these effects on dressing performance can be complicated in stroke patients. However, there are no published reports focusing on the hierarchical structure of the relationships between the activities of daily living and balance function, motor and sensory functions of the affected lower limb, strength of the abdominal muscles and knee extension on the unaffected side, and visuospatial deficits. The purpose of this study was to elucidate the hierarchical and causal relationships between dressing performance and these dysfunctions in stroke patients. This retrospective study included 104 first-time stroke patients. The causal relationship between the dressing performance and age, time post stroke, balance function, motor and sensory functions of the affected lower limb, strength of the abdominal muscles and knee extension on the unaffected side, and visuospatial deficits were examined using path analysis. A hypothetical path model was created based on previous studies, and the goodness of fit between the data and model were verified. A modified path model was created that achieved an almost perfect fit to the data. Balance function and abdominal muscle strength have direct effects on dressing performance, with standardized direct effect estimates of 0.78 and 0.15, respectively. Age, motor and sensory functions of the affected lower limb, and strength of abdominal muscle and knee extension on the unaffected side have indirect effects on dressing by influencing balance function. Our results suggest that dressing performance depends strongly on balance function, and it is mainly influenced by the motor function of the affected lower limb.
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Affiliation(s)
- Takaaki Fujita
- Department of Rehabilitation, Faculty of Health Sciences, Tohoku Fukushi University, Sendai, Miyagi, Japan
- Department of Rehabilitation Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Gunma, Japan
- * E-mail:
| | - Hirofumi Nagayama
- Department of Rehabilitation, Faculty of Health and Welfare, Kanagawa University of Human Services, Yokosuka, Kanagawa, Japan
| | - Atsushi Sato
- Department of Physical Therapy, Yachiyo Rehabilitation College, Yachiyo, Chiba, Japan
| | - Yuichi Yamamoto
- Department of Rehabilitation, Northern Fukushima Medical Center, Date, Fukushima, Japan
| | - Kazuhiro Yamane
- Department of Rehabilitation, Northern Fukushima Medical Center, Date, Fukushima, Japan
| | - Koji Otsuki
- Department of Rehabilitation, Northern Fukushima Medical Center, Date, Fukushima, Japan
| | - Kenji Tsuchiya
- Department of Rehabilitation Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Gunma, Japan
- Department of Rehabilitation, Japan Community Healthcare Organization Gunma Chuo Hospital, Maebashi, Gunma, Japan
| | - Fusae Tozato
- Department of Rehabilitation Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Gunma, Japan
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Verticality Perceptions Associate with Postural Control and Functionality in Stroke Patients. PLoS One 2016; 11:e0150754. [PMID: 26954679 PMCID: PMC4783020 DOI: 10.1371/journal.pone.0150754] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 02/17/2016] [Indexed: 11/19/2022] Open
Abstract
Deficits of postural control and perceptions of verticality are disabling problems observed in stroke patients that have been recently correlated to each other. However, there is no evidence in the literature confirming this relationship with quantitative posturography analysis. Therefore, the objectives of the present study were to analyze the relationship between Subjective Postural Vertical (SPV) and Haptic Vertical (HV) with posturography and functionality in stroke patients. We included 45 stroke patients. The study protocol was composed by clinical interview, evaluation of SPV and HV in roll and pitch planes and posturography. Posturography was measured in the sitting and standing positions under the conditions: eyes open, stable surface (EOSS); eyes closed, stable surface (ECSS); eyes open, unstable surface (EOUS); and eyes closed, unstable surface (ECUS). The median PV in roll plane was 0.34° (-1.44° to 2.54°) and in pitch plane 0.36° (-2.72° to 2.45°). The median of HV in roll and pitch planes were -0.94° (-5.86° to 3.84°) and 3.56° (-0.68° to 8.36°), respectively. SPV in the roll plane was correlated with all posturagraphy parameters in sitting position in all conditions (r = 0.35 to 0.47; p < 0.006). There were moderate correlations with the verticality perceptions and all the functional scales. Linear regression model showed association between speed and SPV in the roll plane in the condition EOSS (R2 of 0.37; p = 0.005), in the condition ECSS (R2 of 0.13; p = 0.04) and in the condition EOUS (R2 of 0.22; p = 0.03). These results suggest that verticality perception is a relevant component of postural control and should be systematically evaluated, particularly in patients with abnormal postural control.
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Bonan I, Leblong E, Leplaideur S, Laviolle B, Tassel Ponche S, Yelnik A. The effect of optokinetic and galvanic vestibular stimulations in reducing post-stroke postural asymmetry. Clin Neurophysiol 2016; 127:842-847. [DOI: 10.1016/j.clinph.2015.03.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 03/19/2015] [Accepted: 03/25/2015] [Indexed: 11/16/2022]
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Hemispheric specificity for proprioception: Postural control of standing following right or left hemisphere damage during ankle tendon vibration. Brain Res 2015; 1625:159-70. [DOI: 10.1016/j.brainres.2015.08.043] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 08/26/2015] [Accepted: 08/28/2015] [Indexed: 11/22/2022]
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Piscicelli C, Nadeau S, Barra J, Pérennou D. Assessing the visual vertical: how many trials are required? BMC Neurol 2015; 15:215. [PMID: 26492863 PMCID: PMC4619006 DOI: 10.1186/s12883-015-0462-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Accepted: 10/06/2015] [Indexed: 11/26/2022] Open
Abstract
Background The visual vertical (VV) consists of repeated adjustments of a luminous rod to the earth vertical. How many trials are required to reach consistency in this measure? This question has never been addressed despite the widespread clinical use of the measurement in stroke rehabilitation. Methods VV perception was assessed (10 trials) in 117 patients undergoing rehabilitation after a first hemisphere stroke. The intraclass correlation coefficient (ICC) and standard error of measurement (SEM) were calculated for each patient category: with contralesional VV bias (n = 48), ipsilesional VV bias (n = 17) and normal VV (n = 52). Results For patients with VV biases, 6 trials were required to reach high inter-trial reliability (contralesional: ICC = 0.9, SEM = 1.36°; ipsilesional: ICC = 0.896, SEM = 0.96°). For patients with normal VV, a minimum of 10 trials was required (ICC = 0.728, SEM = 1.13°). A set of 6 trials correctly classified 96 % of patients. Conclusions In the literature, 10 is the most frequently used number of trials used to assess VV orientation. Our study shows that 10 trials are required to adequately measure VV orientation in non-selected subacute stroke patients. For complex protocols imposing a decrease in the number of trials in each condition, 6 trials are needed to identify VV biases in most patients.
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Affiliation(s)
- C Piscicelli
- Département de Rééducation Neurologique, Centre Hospitalier Universitaire de Grenoble, Grenoble, France. .,Laboratoire de Psychologie et Neurocognition CNRS UMR 5105, Grenoble Université, Grenoble, France.
| | - S Nadeau
- École de réadaptation, Université de Montréal and Centre de recherche interdisciplinaire en réadaptation (CRIR), Québec, Canada.
| | - J Barra
- Laboratoire Vision, Action, Cognition, Université Paris Descartes, Paris, EA7326, France.
| | - D Pérennou
- Département de Rééducation Neurologique, Centre Hospitalier Universitaire de Grenoble, Grenoble, France. .,Laboratoire de Psychologie et Neurocognition CNRS UMR 5105, Grenoble Université, Grenoble, France.
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Piscicelli C, Barra J, Sibille B, Bourdillon C, Guerraz M, Pérennou D. Maintaining trunk and head upright optimizes visual vertical measurement after stroke. Ann Phys Rehabil Med 2015. [DOI: 10.1016/j.rehab.2015.07.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Rousseaux M, Braem B, Honoré J, Saj A. An anatomical and psychophysical comparison of subjective verticals in patients with right brain damage. Cortex 2015; 69:60-7. [DOI: 10.1016/j.cortex.2015.04.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 02/13/2015] [Accepted: 04/12/2015] [Indexed: 10/23/2022]
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Subliminal galvanic-vestibular stimulation recalibrates the distorted visual and tactile subjective vertical in right-sided stroke. Neuropsychologia 2015; 74:178-83. [DOI: 10.1016/j.neuropsychologia.2015.03.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 02/28/2015] [Accepted: 03/02/2015] [Indexed: 11/20/2022]
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Harvey M, Kerkhoff G. Effects of non-invasive brain stimulation on attention: Current debates, cognitive studies and novel clinical applications. Neuropsychologia 2015; 74:1-6. [DOI: 10.1016/j.neuropsychologia.2015.06.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Piscicelli C, Barra J, Davoine P, Chrispin A, Nadeau S, Pérennou D. Inter- and Intra-Rater Reliability of the Visual Vertical in Subacute Stroke. Stroke 2015; 46:1979-83. [DOI: 10.1161/strokeaha.115.009610] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 04/14/2015] [Indexed: 11/16/2022]
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Piscicelli C, Barra J, Sibille B, Bourdillon C, Guerraz M, Pérennou DA. Maintaining Trunk and Head Upright Optimizes Visual Vertical Measurement After Stroke. Neurorehabil Neural Repair 2015; 30:9-18. [DOI: 10.1177/1545968315583722] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. Visual vertical (VV) measurement provides information about spatial cognition and is now part of postural disorders assessment. Guidelines for clinical VV measurement after stroke remain to be established, especially regarding the orientation settings for patients who do not sit upright. Objectives. We analyzed the need to control body orientation while patients estimate the VV. Methods. VV orientation and variability were assessed in 20 controls and 36 subacute patients undergoing rehabilitation after a first hemisphere stroke, in 3 settings: body not maintained (trunk and head free), partially maintained (trunk maintained, head free), or maintained (trunk and head). VV was analyzed as a function of trunk and head tilt, also quantified. Results. Trunk and head orientations were independent. The ability to sit independently was affected by a tilted trunk. The setting had a strong effect on VV orientation and variability in patients with contralesional trunk tilt (n = 11; trunk orientation −18.4 ± 11.7°). The contralesional VV bias was severe and consistent under partially maintained (−8.4 ± 5.2°) and maintained (−7.8 ± 3.5°) settings, whereas various individual behaviors reduced the mean bias under the nonmaintained setting (−3.6 ± 9.3°, P < .05). VV variability was lower under the maintained (1.5 ± 0.2°) than nonmaintained (3.7 ± 0.4°, P < .001) and partially maintained (3.6 ± 0.2°, P < .001) settings. In contrast, setting had no effect in patients with satisfactory postural control in sitting. Conclusion. Subject setting improves VV measurement in stroke patients with postural disorders. Maintaining the trunk upright enhances the validity of VV orientation, and maintaining the head upright enhances the validity of within-subject variability. Measuring VV without any body maintaining is valid in patients with satisfactory balance abilities.
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Affiliation(s)
- Celine Piscicelli
- Grenoble University Hospital, Grenoble, France
- Grenoble-Alpes University, Grenoble, France
| | | | | | | | | | - Dominic Alain Pérennou
- Grenoble University Hospital, Grenoble, France
- Grenoble-Alpes University, Grenoble, France
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Lacour M, Bernard-Demanze L. Interaction between Vestibular Compensation Mechanisms and Vestibular Rehabilitation Therapy: 10 Recommendations for Optimal Functional Recovery. Front Neurol 2015; 5:285. [PMID: 25610424 PMCID: PMC4285093 DOI: 10.3389/fneur.2014.00285] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 12/15/2014] [Indexed: 12/30/2022] Open
Abstract
This review questions the relationships between the plastic events responsible for the recovery of vestibular function after a unilateral vestibular loss (vestibular compensation), which has been well described in animal models in the last decades, and the vestibular rehabilitation (VR) therapy elaborated on a more empirical basis for vestibular loss patients. The main objective is not to propose a catalog of results but to provide clinicians with an understandable view on when and how to perform VR therapy, and why VR may benefit from basic knowledge and may influence the recovery process. With this perspective, 10 major recommendations are proposed as ways to identify an optimal functional recovery. Among them are the crucial role of active and early VR therapy, coincidental with a post-lesion sensitive period for neuronal network remodeling, the instructive role that VR therapy may play in this functional reorganization, the need for progression in the VR therapy protocol, which is based mainly on adaptation processes, the necessity to take into account the sensorimotor, cognitive, and emotional profile of the patient to propose individual or "à la carte" VR therapies, and the importance of motivational and ecologic contexts. More than 10 general principles are very likely, but these principles seem crucial for the fast recovery of vestibular loss patients to ensure good quality of life.
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Affiliation(s)
- Michel Lacour
- Laboratoire de Neurobiologie Intégrative et Adaptative, UMR 7260 CNRS/Université Aix-Marseille, Fédération de Recherche 3C, Centre de St Charles, Marseille, France
| | - Laurence Bernard-Demanze
- Laboratoire de Neurobiologie Intégrative et Adaptative, UMR 7260 CNRS/Université Aix-Marseille, Fédération de Recherche 3C, Centre de St Charles, Marseille, France
- Service d’otorhinolaryngologie et d’otoneurologie, CHU Nord, Assistance Publique-Hôpitaux de Marseille, Marseille, France
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